First Receivers: Managing Blast Injuries upon Hospital Arrival

2020 ◽  
pp. 289-311
Author(s):  
John M. Wightman
Keyword(s):  
Blast Injuries ◽  
Hospital Arrival

scholarly journals Evaluation of Cancer Patients with Older Adult for Awareness and Hospital Arrival Process of COVID-19 Pandemic During: A Cross-Sectional Study

2021 ◽  
Vol 7 ◽  
pp. 233372142199766
Author(s):  
Zeynep Sipahi Karslı ◽  
Berna Kurt ◽  
İbrahim Karadağ ◽  
Berna Çakmak Öksüzoğlu
Keyword(s):  
Cancer Patients ◽  
Older Adult ◽  
Cross Sectional Study ◽  
Arrival Process ◽  
Cross Sectional ◽  
Protective Measures ◽  
Hospital Arrival ◽  
Mortality And Morbidity ◽  
Correlational Design ◽  
Study Results

The study aimed to evaluate the Coronavirus pandemic awareness of cancer patients ≥65 years of age, considered a vulnerable group, and their hospital arrival process, follow-ups and treatments during the pandemic. COVID-19 pandemic was found to increases the mortality and morbidity rates of individuals who aged 65 years and older. The research was conducted with a cross-sectional descriptive correlational design. The sample consist of 77 cancer patients aged 65 years and older adult. Participants were recruited through convenience sampling. In total, 77 patients from the Oncology Hospital located in Ankara from April 29, 2020 to May 20, 2020. Data were collected using a two-part form and a questionnaire. The study was undertaken in accordance with the STROBE checklist for observational studies. Of the participants, 59.7% were female, the mean age was 70 years, 79.2% resided in Ankara and 98.7% traveled to the hospital by car. Looking at the gender and the protective measures taken at home, female participants were found to perform a statistically significant higher level of protective measures. In conclusion, the study results suggest that the restrictions for older adult oncology patients during the pandemic did not negatively affect the delivery of health care.

scholarly journals Two deaths due to explosion of cylinders of liquid petroleum gas

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Nagendra Singh Sonwani ◽  
Navneet Ateriya ◽  
Arvind Kumar ◽  
Anil Kohli
Keyword(s):  
Blast Injuries ◽  
Air Conditioner ◽  
Liquefied Petroleum Gas ◽  
Case Presentation ◽  
Gas Cylinder ◽  
Liquid Petroleum Gas ◽  
Life Threatening ◽  
System Life ◽  
High Pressure Equipment ◽  
Coffee Machine

Abstract Background Cylinder blasts can inflict multi-system life-threatening injuries to one or many persons simultaneously if they are nearby. The explosion in high-pressure equipment produces injuries due to its varied effects. Cases have been reported where the blast occurred in balloon gas cylinder, oxyacetylene gas cylinder, oxygen cylinder, coffee machine, and compressor of a split air conditioner (AC). Most of the cases are accidental. The investigation into the blast circumstances is of utmost importance to find out the manner and device involved. Case presentation Here, we present a report of two cases where victims suffered blast injuries at the same location due to the explosion of two different capacity liquefied petroleum gas (LPG) domestic cylinder and died on the spot. Conclusion The investigation into the blast circumstances is of utmost importance to find out the manner and device involved. Malpractice involving use of cylinder to fill another one might be dangerous for the person involved and present in the vicinity. This practice should be discouraged by lay person.

Vestibular, balance, microvascular and white matter neuroimaging characteristics of blast injuries and mild traumatic brain injury: Four case reports

Brain Injury ◽  
2016 ◽  
Vol 30 (12) ◽  
pp. 1501-1514 ◽  
Author(s):  
Ramtilak Gattu ◽  
Faith W. Akin ◽  
Anthony T. Cacace ◽  
Courtney D. Hall ◽  
Owen D. Murnane ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
White Matter ◽  
Mild Traumatic Brain Injury ◽  
Case Reports ◽  
Blast Injuries

In Hyperacute Recanalization Therapy, Early Hospital Arrival Improves Outcome in Patients with Large Artery Occlusion

2018 ◽  
Vol 79 (5-6) ◽  
pp. 335-341
Author(s):  
Junya Aoki ◽  
Kentaro Suzuki ◽  
Satoshi Suda ◽  
Seiji Okubo ◽  
Masahiro Mishina ◽  
...  
Keyword(s):  
Regression Analysis ◽  
Clinical Outcome ◽  
Multivariate Regression ◽  
Intravenous Thrombolysis ◽  
Multivariate Regression Analysis ◽  
Artery Occlusion ◽  
Favorable Outcome ◽  
Large Artery ◽  
Independent Factor ◽  
Hospital Arrival

Background: It is unknown whether the effect of onset-­­to-door (OTD) time on clinical outcomes differs between ­patients with and without large artery occlusion (LAO) who undergo hyperacute recanalization therapy. Methods: Hyperacute recanalization therapy includes intravenous thrombolysis tissue-plasminogen activator (tPA), and endovascular therapy (EVT). Favorable clinical outcome was defined as modified Rankin Scale of ≤2 at discharge. Results: Among 164 patients, 117 (71%) patients received tPA, 86 (52%) received EVT, and 39 (24%) received tPA and EVT. One hundred and fifteen patients (70%) were classified into the LAO group and 49 (30%) into the non-LAO group. In the total cohort, multivariate regression analysis showed OTD time (OR 0.809 [95% CI 0.693–0.944], p = 0.007) was an independent factor related to the favorable outcome. Similarly, among patients with LAO, OTD was an independent negative factor for the favorable outcome (0.779 [0.646–0.940], p = 0.009). On the contrary, OTD was not associated with the favorable outcome (1.5 [0.7–2.5] vs. 1.7 [1.1–3.2], p = 0.155) in patients without LAO. This was confirmed with multivariate regression analysis, which did not show OTD to be an independent factor for the favorable outcome (0.900 [0.656–1.236], p = 0.516). Conclusion: The effect of early hospital arrival on clinical outcome differed between patients with and without LAO.

scholarly journals 217 The end-tidal and arterial carbon dioxide gradient in serious traumatic brain injury after pre-hospital emergency anaesthesia: a retrospective observational study

2020 ◽  
Vol 37 (12) ◽  
pp. 847.1-847
Author(s):  
James Price ◽  
Daniel Sandbach ◽  
Ari Ercole ◽  
Alastair Wilson ◽  
Ed Barnard
Keyword(s):  
Carbon Dioxide ◽  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Thoracic Injury ◽  
Secondary Brain Injury ◽  
Hospital Emergency ◽  
Hospital Arrival ◽  
Arterial Blood ◽  
End Tidal ◽  
Emergency Anaesthesia

Aims/Objectives/BackgroundIn the United Kingdom (UK), 20% of patients with severe traumatic brain injury (TBI) receive pre-hospital emergency anaesthesia (PHEA). Current guidance recommends an end-tidal carbon dioxide (ETCO2) of 4.0–4.5kPa to achieve a low-normal arterial partial pressure of CO2 (PaCO2), and reduce secondary brain injury. This recommendation assumes a 0.5kPa ETCO2-PaCO2 gradient. However, the gradient in the acute phase of TBI is unknown. Our primary aim was to report the ETCO2-PaCO2 gradient of TBI patients at hospital arrival.Methods/DesignA retrospective cohort study of adult patients with serious TBI, who received a PHEA by a pre-hospital critical care team in the East of England between 1st April 2015 to 31st December 2017. Linear regression was performed to test for correlation and reported as R-squared (R2). A Bland-Altman plot was used to test for paired ETCO2 and PaCO2 agreement and reported with 95% confidence intervals (95%CI). ETCO2-PaCO2 gradient data were compared with a two-tailed, unpaired, t-test.Results/Conclusions107 patients were eligible for inclusion. Sixty-seven patients did not receive a PaCO2 sample within 30 minutes of hospital arrival and were therefore excluded. Forty patients had complete data and were included in the final analysis; per protocol.The mean ETCO2-PaCO2 gradient was 1.7 (±1.0) kPa, with only moderate correlation of ETCO2 and PaCO2 at hospital arrival (R2=0.23, p=0.002). The Bland-Altman bias was 1.7 (95%CI 1.4–2.0) kPa with upper and lower limits of agreement of 3.6 (95%CI 3.0–4.1) kPa and -0.2 (95%CI -0.8–0.3) kPa respectively. There was no significant gradient correlation in patients with a co-existing serious thoracic injury (R2=0.13, p=0.10), and this cohort had a larger ETCO2-PaCO2 gradient, 2.0 (±1.1) kPa, p=0.01. Patients who underwent pre-hospital arterial blood sampling had an arrival PaCO2 of 4.7 (±0.2) kPa.Lower ETCO2 targets than previously recommended may be safe and appropriate. The use of pre-hospital PaCO2 measurement is advocated.

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